黴菌感染
Life-threatening fungal infections: Aspergillosis, cryptococcosis (torulosis), North American blastomycosis, systemic candidiasis, coccidioidomycosis, histoplasmosis, zygomycosis, and infections due to related susceptible species of Conidiobolus, Basidiobolus, and sporotrichosis
Leishmaniasis: Alternative treatment in patients with American mucocutaneous leishmaniasis

Antifungal Agent
Binds to ergosterol altering cell membrane permeability in susceptible fungi and causing leakage of cell components with subsequent cell death. Proposed mechanism suggests that amphotericin causes an oxidation-dependent stimulation of macrophages

Distribution:
1. Vd: 0.38 to 3.99 L/kg
2. Protein binding, plasma: 90%
Excretion:
Urine (2% to 5% as biologically active form); ~40% eliminated over a 7-day period and may be detected in urine for at least 7 weeks after discontinued use

Hypersensitivity to amphotericin or any component of the formulation

B

Because of the potential for toxicity, breast-feeding is not recommended by the manufacturer

1. Cardiovascular: Hypotension
2. Central nervous system: Chills, headache, malaise, pain
3. Endocrine & metabolic: Hypokalemia, hypomagnesemia
4. Gastrointestinal: Anorexia, diarrhea, epigastric pain, heartburn, nausea, stomach cramps, vomiting
5. Hematologic: Anemia
6. Local: Pain at injection site
7. Renal: Renal function abnormality, renal insufficiency
8. Respiratory: Tachypnea
9. Miscellaneous: Fever

Aspergillosis:
0.6 to 0.7 mg/kg/day for 3 to 6 months
Blastomycosis:
0.7 to 1 mg/kg/day for 1 to 2 weeks or until improvement is noted, followed by oral itraconazole for 6 to 12 months
Invasive candidiasis:
0.5 to 0.7 mg/kg/day; dose may be increased to as high as 1 mg/kg/day for infections caused by C. glabrata or C. krusei.
Cryptococcal disease (meningitis, disseminated, or severe pulmonary disease), in patients with HIV:
0.7 to 1 mg/kg/day (with flucytosine or fluconazole or without a concomitant agent) for 2 weeks, then change to oral fluconazole for consolidation/maintenance therapy
Histoplasmosis:
0.7 to 1 mg/kg/day for 1 to 2 weeks (at least 2 weeks in patients with HIV), followed by oral itraconazole for 12 weeks (pulmonary disease) or 12 months (disseminated disease)
Sporotrichosis:
0.7 to 1 mg/kg/day; after the patient has shown a favorable response, can change to oral itraconazole for suppressive therapy for a total duration of therapy of ≥12 months

Store in cool (2~8℃). Do not freeze.